Where to Start When Implementing a Management System

The goal of a management system is to develop people to solve problems and improve performance. A successful and sustainable management system must be rooted in the principles of organizational excellence and leaders must model the way with their behaviors. It is important to remember that a management system is made up of multiple components that are designed to work together to achieve this goal. For this reason, people often struggle with where they should start when implementing a management system. It will not happen overnight, and it will take plenty of discipline, but a management system will transform the way you work.

When organizations or units begin to implement the management system they most commonly start with the daily huddle because it seems easy to implement and gets the whole team involved.  I am an advocate for starting by implementing a stat sheet.

Here are some reasons to start by implementing a stat sheet.

Helps you understand where to focus improvement huddle work

By starting with a status sheet, you have the opportunity to learn about your business and see what is happening every day. During the stat sheet exchanges you will most likely identify patterns in the issues or challenges that come up most often. This will provide insight for where the biggest opportunities may lie to help your team focus improvement efforts when you begin your daily huddle.

Create time to focus on improvement work

Often when people implement a daily huddle they find that their team is busy firefighting and cannot attend a huddle consistently. The stat sheet will open your eyes to many of the challenges facing the team so you can begin to proactively plan for any potential problems and make adjustments early.  This will help reduce the need to firefight and continuously adjust priorities. As your team gets used to creating proactive plans this should help open up time for your team to not only attend huddles but also work on improvements when they are brought forward during the huddle process.

Allows you to begin coaching and teaching problem-solving skills

The status sheet is a way to learn how to ask open-ended questions, go to where the work is happening, listen to those doing the work and begin to coach your team in problem solving.  To be clear, the status sheet is not a way for the leader to go to where the work is done and give the answer!  By asking open-ended questions, you can begin to learn how your team is thinking and can guide them in the problem-solving processes. This in the moment coaching on problem-solving will be a great advantage when it comes time for the team to bring up and solve problems at the improvement huddle.

It may not matter where you start, just start and be consistent. It is important to include all of the elements of a management system to get the best results. Don’t forget to incorporate the principles and behaviors of organizational excellence into each element as you implement. Having a plan, ensuring the support of the team and your leaders to do this work and having the discipline to stick with it will ensure your success.  You need the help and input from your team to learn, see, and improve together.  You will not get it right the first time through.  Having the humility to recognize that and make adjustments based on what you are learning will help the whole team begin to get comfortable with adjusting and growing together.  In the end, when the team is focused on the right work, the patient benefits.  Recognizing that we can see opportunities and solve problems using PDSA will get us to processes that are safer and more sustainable.  It will also allow us to decrease firefighting so we can focus on better care for the patients.


Pam Helander, Faculty


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3 Responses to Where to Start When Implementing a Management System

Sarah Hermsen says: 02/04/2021 at 10:42 am

Could you give some examples of what would be on a status sheet? We implemented tiered daily huddle in August with a handful of must report items like falls, falls with injury, supply issues, critical staffing issues, etc. Are these examples of things you are referencing on a status sheet? Thank you!

Pam Helander says: 02/08/2021 at 10:46 am

A status sheet process is a guided conversation between the leader and his/her direct report to begin to understand the business, proactively plan for the day and coach the direct reports in problem solving. Questions on a status sheet should be open-ended in an effort to understand the thinking of those in the work.

They might look like: Who is at risk for a fall today? What is the plan to keep them safe? Or What staff members are most at risk today? How will you support them? Or What is your plan for the next three patients that will be admitted today? Or What barriers are getting in your way that I can help you with? (or all of the above!)

As you can see, a status sheet is not checklist of questions, but really questions to help you understand the thinking of those doing the work and coach them in problem solving and proactively planning ahead for the day. You as the leader will begin to deeply understand the state of your business and begin to develop your people through coaching every day.

Roger Chen says: 04/14/2021 at 1:22 pm

Thanks Pam Helander for your thoughtful reply. It is important for those of us that have “become Lean thinkers” to go back to “beginner’s mind”, when we assist others that are just starting there journey.


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